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Medicare Risk Adjustment Coding Analyst Jobs in Maine

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Medicare Risk Adjustment Coding Analyst information

What does a Medicare Risk Adjustment Coding Analyst do?

A Medicare Risk Adjustment Coding Analyst reviews medical records and coding data to ensure accurate documentation of diagnoses for Medicare Advantage plans. Their primary goal is to identify and validate chronic conditions and other relevant diagnoses that affect risk scores, which determine the level of reimbursement health plans receive from Medicare. This role requires strong knowledge of ICD-10 coding, risk adjustment models, and regulatory guidelines. Analysts also work closely with healthcare providers and coding teams to improve coding accuracy and compliance.

How does a Medicare Risk Adjustment Coding Analyst typically interact with healthcare providers and coding teams?

Medicare Risk Adjustment Coding Analysts frequently collaborate with healthcare providers, coding teams, and billing departments to ensure accurate and compliant coding of patient diagnoses. This often involves reviewing medical records, providing feedback and educational resources to clinicians, and participating in team meetings to address coding discrepancies or documentation gaps. Strong communication skills are essential, as analysts must explain complex coding guidelines and regulatory requirements in an understandable way. Regular collaboration helps maintain coding accuracy, improve risk scores, and support compliance with CMS standards.

What are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Coding Analyst, and why are they important?

To thrive as a Medicare Risk Adjustment Coding Analyst, you need a strong understanding of ICD-10-CM coding, risk adjustment models, and healthcare compliance, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with coding software, electronic health records (EHRs), and risk adjustment analytics platforms is typically required. Attention to detail, analytical thinking, and effective communication skills help analysts ensure coding accuracy and collaborate with clinical teams. These abilities are essential for optimizing reimbursement, maintaining compliance, and supporting effective healthcare management.

What cities in Maine are hiring for Medicare Risk Adjustment Coding Analyst jobs?

Cities in Maine with the most Medicare Risk Adjustment Coding Analyst job openings:

Nurse Practitioner or Physician Assistant (PRN) - Health Risk Assessments

Southwest Harbor, ME • On-site

Hueman Risk Adjustment Solutions
See more jobs at Hueman Risk Adjustment Solutionsexternal

$102K - $132K/yr

Contractor

Re-posted 11 days ago

Job description

Hueman is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Manset, ME.
This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms, all while enjoying a schedule designed with your preferences in mind. Whether it be for supplemental income or the desire for community connection, this position invites you to become an integral part of the thriving HRA landscape, fostering connections that go beyond the clinic. 

Benefits include:   

  • Competitive compensation and travel reimbursement  
  • Flexible schedule 
  • Comprehensive home assessment training 
  • Dedicated patient scheduling assistance 
  • Liability insurance options 

Position Summary 

Qualified Nurse Practitioners and Physician Assistants interested in this position will have the opportunity to interact with members in a more intimate setting. Unlike a typical clinic visit, this role allows NPs and PAs to connect with patients on a more personal and effective level. Nurse Practitioners and Physician Assistants performing HRAs are not required to treat or prescribe in the home.  

Nurse Practitioner/Physician Assistant Responsibilities 

  • Travel to and from patients’ homes. 
  • Perform comprehensive, non-invasive physical assessments. 
  • Review medical history and ensure accurate and timely documentation.  
  • Conduct medical reconciliation to ensure patient safety and compliance. 
  • Provide basic patient education on wellness and preventative healthcare measures.  

Nurse Practitioner/Physician Assistant Qualifications and Experience Requirements:  

  • Master’s Degree OR commensurate experience and satisfactory completion of NP/PA license 
  • Active State NP/PA license 
  • Active National board certification 
  • Current BLS certification 
  • 12 months of experience as a paid advanced clinical provider is preferred but not required 

To learn more about this position, please use this link to schedule a call with a member of our recruitment team.  
About Hueman 

At Hueman, we're dedicated to guiding you toward fulfilling career opportunities.  

We believe that happiness should be a fundamental part of every role in risk assessment. Our opportunities provide flexibility, extra income, and integration into your local healthcare network. If this resonates with your idea of career satisfaction, allow us to assist you in discovering your next healthcare position! 

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